Rethinking Patient Safety Foundation
Learn how to think and act differently about safety in care beyond the absence of harm.
Estimated time for completion: ~1.5 to 2 hours
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A foundation for care that listens, learns and acts to keep people safe
Why this matters
Strengthening patient safety is fundamental to excellent healthcare and has been a recognized priority in Canada for more than 20 years. The facts above set the stage for a broader look at what patient safety really means in practice. Traditionally, patient safety efforts have focused on reporting and managing incidents, primarily in hospital settings, and often with a focus on physical harm. While that work is important, it only tells part of the story. Patient safety is about relationships, communication, trust and culture. It includes approaches that promote safer care, not just reacting when things go wrong. It also means recognizing that the absence of harm does not necessarily mean that care is safe.
Overview
This foundation invites you to explore a broader and more inclusive understanding of patient safety that is relational, proactive and grounded in the experiences of those receiving and delivering care. Like the other foundations in this learning – health equity, cultural safety and engagement – this one helps us think about how care is experienced and how we can make it safer for everyone.
Some activities are designed for individual reflection. Others work best as a team. You are encouraged to move at your own pace and create space to reflect, share and act.
General objective
To introduce Rethinking Patient Safety and inspire new and innovative approaches to embed safety into everyday work.
After completing this foundation, you will be able to:
Describe key learnings from the Rethinking Patient Safety discussion guide
Start meaningful conversations about safety with colleagues, patients, caregivers and communities
Identify practical actions to strengthen safety in your team or setting
Before you begin
Before diving in, take a moment to gather the materials you’ll need to complete this foundation
Watch and read
Now that you’ve explored why rethinking patient safety matters, take the next step to deepen your understanding and apply it in your own setting. This activity will help you expand your definition of harm and safety and use curiosity and connection to spark change.
Start by watching the Rethinking Patient Safety introduction video and reviewing the discussion guide.
Rethinking Patient Safety discussion guide
Reflection prompts:
What surprised or resonated with you most?
Where might safety be present in your daily work?
Safety conversations
One of the first steps toward making care safer is to start by thinking and talking about it differently. To kickstart your Rethinking Patient Safety journey, we encourage you to begin by having safety conversations with leaders, staff, volunteers, patients, residents, clients, care partners and community partners.
Engaging with others helps us understand what safety means to them and how they may have experienced harm and its impacts. These conversations help shift the culture around safety by inviting in diverse perspectives and building shared understanding.
Let’s get started with your team.
Step 1 – Complete
Complete the “What makes you feel safe?” poster. This activity helps surface what safety means to different people.
“What makes you feel safe?” poster
Step 2 – Build your Safety Wall
Use your team’s completed posters to build a “Safety Wall” in a shared space or virtual environment. This visual display helps keep the conversation going and highlights what safety means to your team and those you serve.
Step 3 - Team conversation - Reflection prompts (team)
What stood out to you in the reading Rethinking Patient Safety or poster activity?
What were your “aha” moments?
Select one question from the discussion guide (page 7) to explore with your team.
Step 4 - Take action – apply what you’ve learned
Now that you’ve started exploring safety within your team, it’s time to expand the circle. Over the next few days, we are asking each team member to have conversations about safety with at least five colleagues and five clients.
This might sound simple, but many people have shared that starting these conversations can feel challenging. The good news is that once they begin, they are often experienced as invaluable and even unforgettable.
Step 5 - Reflect and share back
After everyone has completed their conversations, come back together as a team to discuss:
Who did you speak with?
What was it like to have those conversations?
What did you learn?
What, if anything, might you do differently in your role or your team?
Use this as an opportunity to decide how you might keep safety conversations going in your day-to-day work.
Bringing safety conversations into daily practice
Here are some ways to integrate safety conversations into your daily work:
Add a safety question from the Rethinking Patient Safety discussion guide to team huddles, team meetings or shift handovers
Start informal conversations with colleagues during the day
Expand your Safety Wall by inviting patients, caregivers, communities, care partners, and colleagues to fill out a “What makes you feel safe?” poster
Bring safety questions into your interactions with patients: during morning rounds, intake, home visits or family meetings
Share conversation starters or the “How to Have Safety Conversations” resources with clients and colleagues
If you’re unsure how to start, try practicing:
with a colleague through role-play
with a friend or family member to build confidence
Tips for success
Keep the tone open and curious
Use everyday language
Follow the lead of the person you’re speaking with
Be okay with pauses or silence
It’s not about getting it perfect – it’s about building trust
Tips for hosting a safety conversation
Make it safe to talk about safety – A big part of making safety conversations successful involves normalizing them. However, not everyone will feel safe to talk about safety. Before safety conversations can take place, recognize power dynamics that may exist and work to create environment that encourages open dialogue and promote exploration and curiosity for all.
Ask questions – Safety conversations are built around the practice of asking questions. By asking questions, you are taking the first step and ensuring that the onus is not on others to speak up.
Listen– Listen to and learn from others. Acknowledge them, as experts. Respect cultural differences. Active listening and reflection, recognizes that all perspectives are valued and heard.
Reflect – On what you are hearing and share what you are learning with others
Act – Follow through on the information and insights you have collected from your events. Prepare a clear outline of steps that will be taken so everyone knows what to expect and when.
Keep having safety conversations (don’t just have one) – Establish a schedule for hosting safety conversations events to ensure everyone has an opportunity to be part of safer care. Include as part of the ‘onboarding’ process from new staff (clinical and non-clinical), leaders, Board members, and volunteers.
Safety begins with a conversation. One of the most powerful ways to improve patient safety is to start a conversation. It might seem simple, but by asking questions and listening to understand, we can identify areas for improvement and build a culture of trust and openness. Reflect on how engaging with patients, caregivers, and colleagues can lead to culturally safe and equitable care, and care that is safer for all.
This foundation is just a starting point, a way to demonstrate that small actions can spark big changes. By asking questions and acting on what we learn, we can create a culture where safety is viewed as a shared responsibility that begins with every conversation. Together, we can build a system where safety is not just the absence of harm, but a foundational element of everything we do.
There are many ways to continue your journey with Rethinking Patient Safety. Whether you're looking to deepen your understanding, try something new with your team, or share what you've learned, the resources below can help you take the next step.
Join national learning and awareness efforts
Participate in Canadian Patient Safety Week. Connect with others across the country who are working to improve patient safety. Explore stories, tools and conversations that spark meaningful change.
Enroll in the PSE e-learning modules. Learn more about patient safety fundamentals and how to apply them in real-world settings through short, self-paced online modules.
Looking for something specific? Try one of these activity cards to discover creative and practical tools to help you shift how you think and act for patient safety in your own environment.
Looking for something specific? Try one of these activity cards to discover creative and practical tools to help you shift how you think and act for patient safety in your own environment.
If you are looking to | Consider trying this activity |
Share information about Rethinking Patient Safety | |
Spot outdated, unnecessary or clunky processes and a playful way to declutter work routines | |
Sharpen your leadership knowledge and skill for patient safety | |
Expand your understanding of healthcare harm | |
Ask “How safe is our care today?” using all your senses | |
Introduce or improve your safety huddles by using safety tickets and board | |
Improve a process by bridging the gap between work-as-imagined and work-as-done | Comic Strip conversation (coming soon) |